双血管缝合器在胸-腹主动脉瘤腔内治疗中的临床应用

Clinical utility of double vascular closure in endovascular aneurysm repair of thoraco-abdominal aortic aneurysm

目的评估在胸-腹主动脉瘤患者的治疗中双血管缝合器和手术切开2种入路方式的手术安全性和治疗效果。方法 2010年1月至2014年1月在大庆油田总医院住院并且接受介入治疗的患者50例,其中男性27例,女性23例,年龄为37~84岁,平均年龄为(58.21±11.95)岁。根据入路方式分为缝合器组和手术切开组,各25例。比较2组患者非支架置入步骤的手术持续时间,观察止血时间、下床走动的时间和并发症。结果比较手术切开组非支架置入步骤的手术持续时间和缝合器组非支架置入步骤的手术持续时间,(82.0±20.0)min vs(9.0±2.0)min,P<0.001,差异具有统计学意义;2组间下床走动时间比较,3 d vs 4~6 h,P<0.001,差异具有统计学意义;临床随访时间为1个月,均无手术伤口相关并发症发生。结论双血管缝合器在胸-腹主动脉瘤治疗中应用的安全性优于手术切开组,缩短了止血时间和下床走动时间。

Objective To evaluate the safety and efficacy between two methods for double vascular closure devices and surgical incision in the treatment of patients with thoraco-abdominal aortic aneurysm.Methods From January 2010 to January 2014,50 cases of the patients were treated by interventional therapy at Daqing Oilfield General Hospital.There were 27 male patients and 23 female patients.Age ranged from 37 to 84 years and the average age was(58.21±11.95) years.According to the road divided into vascular closure groups and surgical staplers incision group.The operation time of the two groups of patients with non stenting procedure was compared,and bleeding during surgery time,walk around bed time and complications were observed.Results The time between the surgical staplers incision group with non-stent step and the vascular closure group with non-stent step was compared [(82.0±20.0) min vs(9.0±2.0) min,P <0.001)].The walk around bed time between two groups(3 days and 4-6 hours,P <0.001) had significantly shorter.Through one-month clinical follow-up,there was no complications related to surgical wound.Conclusion The safety of double vascular closure devices in the treatment of thoraco-abdominal aortic aneurysms is better than surgical incision group.The bleeding time and the time of get out of bed to walk is shortened.